• Hasu D L Patel, Steven Dryden, Amit Gupta, and Swee Chai Ang.
• Department of Plastic Surgery, Barts and the London NHS Trust, Whitechapel, London, E1 1BB, England. hasu.patel@bartsandthelondon.nhs.uk
• J Trauma Acute Care Surg. 2012 Jul 1; 73 (1): 276-81.

BackgroundTraumatic amputation of limbs caused by bomb blast carries a high mortality; we present our experience of 07/07 London terrorist bombing that resulted in a large number of survivors with amputated limbs. We think that the unique underground bombing, the shape of the carriages, and the enclosure by the underground tunnel caused amputation of the limb by the channeling of the blast wave as a result of the device being floor based, which resulted in lower-limb amputation without other fatal primary blast injuries. We present our results of the traumatic amputation in the fatalities and survivors as well as the possible mechanism and protective measure that could save lives.MethodsData for traumatic amputations were collected from several sources and made anonymous. Traumatic amputations were specifically classified in both the survivors and the fatalities.ResultsOur results have shown that 24.5% of those with traumatic amputations will survive. Most of the lower-limb amputations occurred in the shaft of the long bones. Only one person with an upper limb amputation survived the injuries.ConclusionThis study does not support the previously held belief that traumatic amputations from a bomb blast results from simple avulsions by the blast winds. However, it reinforces the belief that the principal mechanism of primary traumatic amputation of the limbs in such circumstances occurs primarily [corrected] from the direct coupling of blast waves, resulting in a fracture of the long bone rather than at a joint. This study is unique because it looks at the effects of blast at a very close range (<2 m) at the four London bombing scenes.Level Of EvidenceEpidemiological study, level V.

19 keywords...

hide…